Birch Rebecca J, Burr Nick E, Taylor John C, Downing Amy, Quirke Phil, Morris Eva J A, Turvill James, Thoufeeq Mo
Pathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UK
Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
BMJ Open Gastroenterol. 2025 Jan 8;12(1):e001629. doi: 10.1136/bmjgast-2024-001629.
Studies in the USA examining the relationship between ethnicity and colorectal cancer (CRC) identified significant variation. This study sought to examine the relationship between ethnic group, route to diagnosis, early-onset CRC and stage at diagnosis in the English National Health Service.
Data from COloRECTal cancer data Repository for all individuals diagnosed with CRC (International Classification of Diseases version 10, C18-C20) between 2012 and 2017. A descriptive analysis of the characteristics of the study population was performed. Multivariable logistic regression models were used to assess the association between ethnicity, route to diagnosis, stage at diagnosis and early-onset CRC.
Early-onset CRC was least common in those in the white ethnic group (5.5% diagnosed <50, vs 17.9% in the Asian, 15.5% in the black and 21.8% in the mixed and multiple ethnic groups, p<0.01). Diagnosis following a 2-week wait referral was significantly less common among individuals from the Asian, black, other and unknown ethnic groups than the white ethnic group (Asian OR 0.84, 95% CI 0.79 to 0.91, black OR 0.86, 95% CI 0.79 to 0.93, other OR 0.81, 95% CI 0.73 to 0.90 and unknown OR 0.70, 95% CI 0.66 to 0.73). The Asian ethnic group had significantly lower odds of emergency diagnosis than the white ethnic group (OR 0.90, 95% CI 0.83 to 0.97). Following adjustment, individuals from the Asian ethnic group were significantly less likely, than their white counterparts, to be diagnosed at stage IV (OR 0.82, 95% CI 0.76 to 0.88).
This study identified different demographic profiles of those diagnosed with CRC between broad ethnic groups, highlighting the need to consider access to diagnostic CRC services in the context of ethnicity.
美国的研究对种族与结直肠癌（CRC）之间的关系进行了考察，发现存在显著差异。本研究旨在探讨英国国家医疗服务体系中种族群体、诊断途径、早发性结直肠癌与诊断时分期之间的关系。
来自结直肠癌数据储存库的数据，涉及2012年至2017年间所有被诊断为结直肠癌的个体（国际疾病分类第10版，C18 - C20）。对研究人群的特征进行了描述性分析。使用多变量逻辑回归模型来评估种族、诊断途径、诊断时分期与早发性结直肠癌之间的关联。
早发性结直肠癌在白人种族群体中最不常见（5.5%的患者诊断时年龄小于50岁，相比之下，亚洲人为17.9%，黑人为15.5%，混合及多个种族群体为21.8%，p<0.01）。在亚洲、黑人、其他及不明种族群体中，经2周等待转诊后确诊的情况明显少于白人种族群体（亚洲人优势比0.84，95%置信区间0.79至0.91；黑人优势比0.86，95%置信区间0.79至0.93；其他优势比0.81，95%置信区间0.73至0.90；不明优势比0.70，95%置信区间0.66至0.73）。亚洲种族群体进行急诊诊断的几率显著低于白人种族群体（优势比0.90，95%置信区间0.83至0.97）。调整后，亚洲种族群体的个体相比白人个体，在IV期诊断的可能性显著降低（优势比0.82，95%置信区间0.76至0.88）。
本研究确定了不同种族群体中结直肠癌患者的不同人口统计学特征，强调在种族背景下考虑获得结直肠癌诊断服务的必要性。
